The National Institute for Health and Care Excellence, or NICE, has lowered the threshold for access to some biologics for patients with ‘moderate to active’ rheumatoid arthritis. The move provides treatment access more similar to that of patients in most of Western Europe.
Barriers to Treatment
Since the advent of NICE in the early 2000s, the UK has had to live with the highest barriers within Western Europe to accessing such therapies.
There are no such eligibility restrictions in Ireland and many other European countries. There, choice of treatment is determined by the prescribing clinician, who can use the most appropriate treatment in collaboration with the patient, free from cost restrictions.
Value of Timely Access
Ample scientific evidence demonstrates that earlier access to biologic treatment can drastically reduce long-term disability. It can also ease pressure on health services and reduce the negative impact on individuals’ physical and mental health as well as their working lives.
With the reduction in the cost of some of these advanced treatments due to the introduction of biosimilars, the National Rheumatoid Arthritis Society and the British Society for Rheumatology commenced talks with NICE to highlight the ideal opportunity to address the issue.
Until now only those people with severe disease have been able to have advanced biologic and targeted synthetic disease-modifying therapies prescribed for them as part of their National Health Service treatment.
These drug options, now accessible for those with active, moderate disease, will give an estimated 25,000 thousand people hope of a significantly better quality of life. For many, it will end years of living with disease that is not optimally controlled.
Impact of Rheumatoid Arthritis
Rheumatoid arthritis is a painful, progressive, systemic autoimmune disease which affects every aspect of a person’s life.
A recently published National Rheumatoid Arthritis Society study looking at the level of suffering of people with ‘moderate’ disease highlighted that people not currently treated with advanced therapies experience profound difficulties in everyday living across a broad range of measures. The study surveyed over 600 people with rheumatoid arthritis in the UK who have active disease but, until now, have been unable to access these advanced therapies.
Ninety percent had experienced flares of their disease in the previous 12 months, with almost a quarter experiencing six or more flares.
Next steps will be the implementation of local prescribing pathways to reflect this change in the NICE guidelines. The recent publication of the NICE guideline on Shared Decision Making, will play a vital role in ensuring that all RA patients can participate in decisions about their treatment progression.
The impact of this NICE decision on many thousands of people’s lives cannot be underestimated.
Clare Jacklin is CEO at the National Rheumatoid Arthritis Society.